Washakie County sees increases in COVID-19 cases, deaths

WORLAND — In two weeks Washakie County COVID-19 cases increased five-fold from five cases to 28 as of Tuesday, with most of the new cases attributed to the outbreak at the Worland Healthcare and Rehabilitation Center (WHRC).

As of Tuesday there are now 12 total cases among residents at WHRC, which includes one that will be counted in Montana. There are nine total staff cases — six reside in Washakie County, two in Big Horn County and one in Hot Springs.

There has also been two reported deaths associated with this outbreak, both adult male residents of the facility.

Of Washakie County’s total COVID-19 case count, there were four community-wide cases reported on Saturday.

The origin of the 28th case that was reported on Tuesday was uncertain at press time, but according to Washakie County Public Health it is believed to be an additional case from the WHRC.

OUTBREAK

According to Wyoming Department of Health Public Information Officer Kim Deti on May 19, “The situation [at the WHRC] was identified because two staff members who had symptoms did the right thing and got tested. However, at this point, no one should assume those staff members are the reason the virus was introduced into the environment. We do not yet have a final answer as to what occurred.”

Washakie County Health Officer Dr. Ed Zimmerman posted on Facebook Monday that “a resident transferred to the facility and ended up being the positive that likely started all of this.”

Deti said Tuesday, however, “We are continuing to investigate multiple clusters in the state and attempting to identify possible sources of introduction. We may not be able to offer an exact explanation of how the virus first entered the facility. It’s not always clear.”

The first death was reported on Thursday, May 21 and the second death on Tuesday, May 26.

TESTING

During a press conference last Wednesday, May 20,

Wyoming Health Officer Dr. Alexia Harrist said, “One group at risk we are especially concerned about are the residents of long-term care facilities such as nursing homes and assisted living.”

She said the state was beginning a proactive testing program focused on long-term care facilities with two approaches. The first approach is for facilities without a current outbreak. Facilities must sample 20% of staff and residents every two weeks.

“We will work with the facilities to set up a plan that works best for them,” she said. “This program will help ensure we are not missing potential outbreaks for citizens who are most vulnerable during this pandemic. The earlier we can identify a potential trouble spot, we can take action to limit the spread.”

Harrist said the second approach is for facilities with an outbreak like the one at the Worland center. Deti said, “We will continue to test weekly until we are sure there is no longer transmission within the facility.”

After the initial round of testing the weekend of May 16-17 showed 11 cases in the center, another round of testing was conducted on May 22 with eight new COVID-19 cases from the center, four each staff members and residents.

Deti said negative staff and residents will continue to be tested weekly. Residents and staff who have tested positive are grouped together to limit additional transmission.

Harrist said asymptomatic and mild cases can contribute to transmission in these facilities and the testing will be able to detect these cases.

Zimmerman, however, also posted, “Even when tested there is a significant false negative rate.”

Deti said, “The test the Wyoming Public Health Laboratory uses likely has a very low rate of actual false negative results. There are other factors that affect the perception of what is happening and that could lead to an impression of false results. One difficulty in the detection of clusters are asymptomatic cases. People can transmit the disease before they have symptoms and know they are potentially ill and then before they are tested. It’s also possible for samples to be collected early after their exposure and for people to test positive later because it can take up to 14 days after exposure to COVID-19 for someone to become ill.

“In addition, for many people in general who test negative, they probably were not infected at the time the sample was collected and there is likely another cause of their symptoms. There are other viruses still circulating.

“As with any testing platform, there is likely some variability in actual, not perceived, false-negative rates. But, again, the testing we are using at the state lab is a very sensitive testing platform and we have high confidence in the results.”

According to Washakie County Incident Command Team, residents who test positive for COVID-19 are isolated in a separate area of the nursing home, with dedicated staff caring for them.

WHRC RESPONSE

The Worland Healthcare and Rehabilitation Center, through its “community spokesperson,” issued this statement on Wednesday, May 20, prior to the report of the death.

“At Worland Healthcare and Rehabilitation Center, our top priority is ensuring the health and well-being of our community. In order to fully measure the status of COVID-19 at our community and to equip our caregivers to respond quickly and effectively, we completed testing on all residents and team members on May 15 and 16, even though no community members present were showing signs or symptoms. Our ability to test the entire community in such a short time is a direct result of the state’s quick response in delivering the kits needed to test for COVID-19 on-site. That removed the need for anyone to leave our community and expose themselves to unnecessary risk. All tests were administered in a safe and highly controlled setting in strict accordance with CDC guidelines.

“Our team worked swiftly to test all team members and residents, and, within 48 hours, we had received the test results and secured a dedicated COVID-19 unit to quarantine and care for any positive residents.

“Upon being made aware of test results, we immediately informed all residents, team members and families. At this time, these residents remain under quarantine in our dedicated COVID-19 unit where they are receiving the appropriate medical care. The team members who have tested positive are all under self-quarantine away from the community.”

According to the prepared statement, “The caregivers – all of whom wear department-of-health-required personal protective equipment (PPE) at all times – are actively monitoring residents and staff for signs and symptoms of COVID-19, including conducting regular temperature checks.

“We would like to thank the Worland community for all they have done to provide assistance as we continue to fight the spread of COVID-19. From delivering meals to our caregivers to helping set up a testing and sanitation station for our team members to use before and after work, we are overwhelmed by the acts of kindness and support demonstrated by the residents of Worland every day.”

COMMUNITY CASES

Of the 28 cases (five of the early cases have recovered) there have also been four additional COVID-19 cases unrelated to the center outbreak. There are two male cases and two female cases with an age range from 40-90. Investigations are still ongoing for those new cases, according to the county incident management team (IMT).

Anyone identified as a close contact of a confirmed or probable case will be notified.

Of the positive cases in Washakie County there have been two reported hospitalizations at Washakie Medical Center, one of which is believed to be a case from the WHRC. It is unknown at this time if the second WMC hospitalization is a WHRC case or one of the community cases.

Another hospitalization is the Montana case, according to the Wyoming Department of Health.

COVID-19 can be transmitted by infected people who don’t yet have symptoms. Disease symptoms may appear 2 to 14 days after virus exposure and include fever, cough, shortness of breath or difficulty breathing, chills, muscle pain, headache, sore throat and new loss of taste or smell.

According to the Washakie County IMT, it is important to remember that the virus that causes COVID-19 can spread from a person before they have symptoms. Take action to slow the spread by wearing a cloth face covering in public spaces, keeping at least six-feet of physical distance and frequently washing your hands.

For more information about COVID-19 from WDH, visit: https://health.wyo.gov/publichealth/infectious-disease-epidemiology-unit/disease/novel-coronavirus/.